Experienced endovascular interventionalists objectively improve their skills by attending carotid artery stent training courses

Eur J Vasc Endovasc Surg. 2008 May;35(5):541-50. doi: 10.1016/j.ejvs.2007.12.017. Epub 2008 Feb 8.


Objective: Carotid artery stenting (CAS) is an advanced endovascular intervention with a steep learning curve. Virtual reality (VR) simulation has been proposed as a means to train and objectively assess technical performance.

Aim: To objectively assess psychomotor skills acquisition of experienced interventionalists attending a two-day CAS course, using a VR simulator.

Methods: Both cognitive and technical skills of 11 interventionalists were trained in a two-day course using didactic sessions, case reviews, supervised VR simulation and live-cases. Pre- and post-course skills were assessed through performance on the same CAS procedure using metrics derived from the simulator.

Results: Significant differences were noted between pre- and post-course performance for procedure (36 vs. 20min., p=0.005), X-ray (20 vs. 11min., p=0.016) and delivery-retrieval time of the embolic protection device (12 vs. 9min., p=0.007). Advancement of the guiding catheter without a leading wire occurred to a greater extent pre- versus post-course (199 vs. 152mm., p=0.050) as did spasm of the internal carotid artery (4 vs. 2, p=0.049).

Conclusions: This study has objectively proven a benefit for experienced interventionalists to attend CAS courses for skills acquisition measured by a VR simulator. These data can be used to offer participants an insight into their skills and objectively audit course efficacy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angioplasty, Balloon / education*
  • Carotid Stenosis / therapy*
  • Clinical Competence
  • Computer Simulation
  • Curriculum
  • Education, Medical, Continuing
  • Educational Measurement
  • Humans
  • Models, Cardiovascular
  • Psychomotor Performance*
  • Stents*
  • User-Computer Interface